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CENTERWELL SENIOR PRIMARY CARE-SOUTH MOUNTAIN
NPI 1366199655
Internal Medicine in Phoenix, AZ

Active since March 07, 2022CLIA 03D2260329 · Waiver
2070 E BASELINE RD, PHOENIX, AZ 85042(602) 834-9071(877) 541-4239 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 2024, Oct 31, 2022, Mar 7, 2022 (3 updates tracked since 2022).

About Centerwell Senior Primary Care-south Mountain NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTERWELL SENIOR PRIMARY CARE-SOUTH MOUNTAIN (NPI 1366199655) is a healthcare organization registered as an internal medicine in Phoenix, Arizona and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through May 16, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1366199655
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE AZ PC
Location Address2070 E BASELINE RDPhoenix, AZ 85042-6948
Mailing Address6101 Blue Lagoon Dr Ste 200Miami, FL 33126-3168 · (305) 500-2000
Phone(602) 834-9071
Fax(877) 541-4239
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateMarch 7, 2022
Last NPPES UpdateAugust 19, 20243 updates tracked since enumeration
NPPES CertifiedAugust 19, 2024
✔ NPI 1366199655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
2070 E BASELINE RD, Phoenix, AZ 85042
Open in Google Maps ↗

Other Names 1

Doing Business AsCenterwell Senior Primary Care-south Mountain

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2260329

Centerwell Senior Primary Care-South Mountain · Phoenix, AZ
Active · expires May 16, 2028
CLIA Number03D2260329
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2026
Certificate Expiration DateMay 16, 2028
Laboratory DirectorDr. Sahar Zuberi
Laboratory Phone(602) 834-5439
Laboratory LocationCenterwell Senior Primary Care-South Mountain2070 E Baseline Rd, Phoenix, AZ 85042
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THIHALOLIPAVAN SAYALOLIPAVAN MD
Family Medicine
2070 E BASELINE RD
PHOENIX, AZ 85042
Maricopa County (602) 834-9071
ULDA ELIZABETH RIVERA PA
Physician Assistant
2070 E BASELINE RD
PHOENIX, AZ 85042
Maricopa County (602) 834-9071
VANESSA PORRAS FNP-C
Nurse Practitioner (Primary Care)
2070 E BASELINE RD
PHOENIX, AZ 85042
Maricopa County (602) 834-9071

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centerwell Senior Primary Care Az PC's NPI number?

The NPI number for Centerwell Senior Primary Care Az PC is 1366199655. It was assigned to this organization in the NPPES registry on March 7, 2022. The provider is doing business as Centerwell Senior Primary Care-South Mountain.

Where is Centerwell Senior Primary Care Az PC located?

Centerwell Senior Primary Care Az PC is located at 2070 E Baseline Rd, Phoenix, AZ 85042. The listed phone number is (602) 834-9071.

What is Centerwell Senior Primary Care Az PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Centerwell Senior Primary Care Az PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2260329) is associated with this NPI, valid through May 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Az PC was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.